Interna tional Jo urna l o f M ultidisciplina ry Research and Develo pment 2015 ; 2 (1 ): 28 6-289
IJMRD 2015; 2(1): 286-289
www.allsubjectjournal.com
Received: 07-12-2014
A long term chronic fibrotic adhesion of elbow
Accepted: 15-01-2015 muscles alleviated by applying hivamat 200 deep
e-ISSN: 2349-4182
p-ISSN: 2349-5979 oscillation therapy
Impact factor: 3.762
Yuin-Chiau Gao Yuin-Chiau Gao, Chiung-Chi Peng, Robert Y. Peng
Department of Rehabilitation,
Taipei Medical University
Abstract
Hospital, Taipei Medical
University, 250 Wu-Xin Street,
Deep Oscillation® clinically is good for reducing fibrosis and scar tissues. A male, age 75, has had a
Xin-Yi District, Taipei 11031. painful and weakened right elbow for 35 years, which was diagnosed to be fibrotic adhesion with
musculi extensor capri ulnaris and extensor digitorum communis at the right elbow. HIVAMAT® 200
Chiung-Chi Peng (Physiomed Electromedizin AG, Germany) was applied five times a week at frequency=40 Hz; modes
Graduate Institute of Clinical =5, pulse time =3, pause time=1; each treatment for 12 min; and duration of treatment = 45 days (still
Medicine, College of Medicine, going). The physiological data were greatly improved: elbow strength (initial vs. post-treatment) 05.kg
Taipei Medical University, 250 vs. 2.5 kg; shaking frequency, 1/15 min vs. 1/32 min; interior bending (degreeo), 45o vs. 30o; pronation
Wu-Hsing St., Xin-Yi District, (degreeo), 70o vs. 102o; adhesion relaxing sound ‘Kachi!’, big vs. lower; midnight pain, always vs.
Taipei 11031. disappeared. Conclusively, HIVAMAT® 200 is good for the soft tissue pains or chronic inflammation
that are not treatable by means of common physical therapy.
Robert Y. Peng
(A)Research Institute of Bio Keywords: Deep Oscillation Therapy®; HIVAMAT® 200; muscular fibrotic adhesion.
Medicne, School of Medicine
and Nursing, Hungkuang 1. Introduction
University, 1018, Sec. 6, The name ‘HIVAMAT®’ is short for a rather wordy description: (HI) Histological (VA)
Taiwan Boulevard, Shalu
Variable (MA) Manual (T) Technique (HIVAMAT®). By applying to rehabilitation it has
District, Taichung City 43302,
Taiwan. been referred as the Deep Oscillation® Therapy. Deep Oscillation®originated in Germany in
(B)Research Institute of 2007. HIVAMAT® 200 (Physiomed Electromedizin AG, Hutweide 10, D-91220
Medical Sciences, Taipei Schnaittach/Laipersdorf, Germany) is a massage-intensifying system which is successfully
Medical University, 250 Wu-
Xin St., Xin-Yi District, used in various areas of Physical Therapeutic Medicine (Fig. 1). Mechanically, Deep
Taipei 11031. Oscillation® uses the HIVAMAT to create low frequencies of gentle electrostatic impulses
that ‘knead' the skin's tissue by attracting and releasing it between 5-250 times a second.
Deep Oscillation® had significant and clinically relevant influence on swelling, spontaneous
pain and tenderness (Johanning-Csik, 1994).
Deep Oscillation® is good for 1) anti-fibrosis; 2) reduction in bruising; 3) accelerating wound
healing (dynamic wound healing) (Mikhalchik, Titkova, Anurov, Suprun, Ivanova,
Trakhtman & Reinhold, 2005a; Korkina, Reinhold, Rota, Primavera & Raskovic, 2007)
based on anti-inflammatory, anti-oxidant, decreasing swelling and edematous phenomena
(Mikhalchik, Titkova, Anurov, Suprun, Ivanova, Trakhtman & Reinhold, 2005b) including
lymph oedema (Hernández Tápanes, 2010); 4) enhancing nutrient flow; 5) detoxification
treating cellulite (Korkina, Reinhold, Rota, Primavera & Raskovic, 2007); 6) stimulating
Correspondence:
Robert Y. Peng
collagen production and cell regeneration; 7) lifting and toning muscles; 8) improving skin
(A)Research Institute of Bio elasticity; 9) anti-aging treatment for face-neck-décolleté; 10) respiratory problems (Korkina,
Medicne, School of Medicine 2005); 11) scar tissues; 12) surgery after care; 13) burns treatment (Hernández Tápanes,
and Nursing, Hungkuang 2010); 14) stimulating milk flow (Johanning-Csik, 1994); and 15) sports injuries (Aliyev,
University, 1018, Sec. 6, 2009). A lot of experience has been accumulated with Deep Oscillation® in other indications
Taiwan Boulevard, Shalu
District, Taichung City 43302,
like reducing pain, promotion of motoricity, improvement in trophicity and quality of the
Taiwan. tissue (Aliyev, 2009). Scientifically researched frequencies can penetrate the skin tissue by 8-
(B)Research Institute of 12 cm and have been proven to remove excess inflammatory caused by products, protein
Medical Sciences, Taipei solids and lymph fluid buildup (Aliyev, 2009). The soft mode of action is the reason that in
Medical University, 250 Wu- contrast to other electric and mechanical therapies it is no contraindication in immediate
Xin St., Xin-Yi District,
Taipei 11031.
therapy (Aliyev, 2009).
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International Journal of Multidisciplinary Research and Development
2. Instrument Overview
Fig 3: Schematic showing elbow interior bending movement.
(Modified from “Search elbow muscle anatomy;
www.Taiwan.com/elbow+muscle+anatomy”).
At the same time, he has to shake his elbow from time to
time from the interior side of elbow 45o angle degree down
to the exterior side of elbow to release the adhesive sensation
and pain, and each time the adhered parts would utter a
Fig 1: Shows the instrument HIVAMAT® 200. sound yelling ‘Kachi! Kachi!’ from the elbow and the
frequency was very high (approx. once every 15 min). The
initial accident occurred about 35 years ago (since year 1980)
Fig 1: The outerlook of HIVAMAT® 200. a) Front panel; b) Gear
panel. (Modified from “Physiomed Electromedizin AG”). when he climbed up a reactor (HD=3 m1.8 m) in a
factory, suddenly he fell down to ground when he supported
3. Chief complaint himself with a single right palm widely stretched. The
A male patient Mr. PX, age 75, (Pathological Record: sudden stress caused his right palm fingers over extended
0075924-7, Taipei Medical University Hospital) appeared at and distorted, yet now painless (not shown). As mentioned,
OPD of rehabilitation on June 1, 2014, complaining about his initially before treatment, he was totally unable to furnish
painful right elbow unable to raise anything even as light as freely elbow pronation movement (Fig. 2) and interior
0.5 kg. bending movement (Fig. 3).
He claimed about his long term (about 35 years long) of
elbow weakness, painful, sour sensation with frequent loss of 4. Diagnosis
strength in raising anything heavier than 0.5 kg. He showed He showed adhesive capsulities of elbow. At the same time
much difficulty in pronation movement (Fig. 2). the damages with musculi extensor capri ulnaris and extensor
digitorum communis at his right elbow were apparently
noted (Fig. 4) which is supposed to have induced the long
term chronic inflammatory adhesion of these muscles.
Fig 2: Schematic showing pronation movement. Fig 4: Schematic showing the muscles around exterior of right
elbow.
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International Journal of Multidisciplinary Research and Development
(Depicted from Kibiuk, 2010). (Modified from “Search Therapy, 2014). HIVAMAT® 200 Physical Therapy
elbow muscle anatomy; positively influences inflammation and cell regeneration
www.Taiwan.com/elbow+muscle+anatomy”). The patient (Touching Well net, 2014).
was hurt at musculi extensor capri ulnaris and extensor Deep Oscillation® stimulates blood flow and thus prevents
digitorum communis. white blood cells building up in the vessels. So fewer
inflammatory chemicals are produced (Mikhalchik, Titkova,
During the past seven years, he had received many times of Anurov, Suprun, Ivanova, Trakhtman & Reinhold, 2005a).
multiple treatments before coming to our OPD. He This reduces the swelling, heat and redness of inflammation,
intermittently received acupuncture, at least ten times at but still allows healing to take place. It soothes pain and it is
intervals of 4-6 months, and moxibustion at least four times very relaxing. In chronic inflammation, tissues start to
since three years ago, however, all in vain. thicken and lose elasticity due to the build-up of fibrosis.
Deep Oscillation® helps to disperse fibrosis by gently
5. Treatment disrupting and “loosening” it. This enables the patient to gain
For treatment of his long term chronic inflammatory better movement in the affected area, which, in turn, can
adhesion of musculi extensor capri ulnaris and extensor stimulate a virtuous cycle where increased flexibility makes
digitorum communis, the physiotherapist decided to apply it harder for further fibrosis to develop and the client can get
intensive deep massage with HIVAMAT® 200. The onto the road to recovery.
treatment program was applied five times a week. Each time This selected medium and low frequencies are effective for
the massage frequency was set at a medium frequency of 40 larger area and deeper tissue (Table 1). HIVAMAT® 200 is
Hz. The instrument modes were operated at position (mode) aimed at supporting, intensifying and thus improving the
=5, pulse time=3, pause time=1, to yield an intense vibration. effects and lastingness of manual massage techniques, such
The duration for each time treatment was 10-12 min. This as classic massage, anti-edema therapy, vibration-intensified
treatment started from December 1, 2014 until present. The massage, massage in sports and manual lymphatic drainage.
prognosis was evaluated from the duration starting from Due to its enormous depth effect with minimal mechanical
December 1, 2014 to January 10, 2015. Worth noting, the action, the application of the HIVAMAT® 200 opens up the
therapy is still going on expecting to get better outcome. possibility of treating indications, with various effects to
ensure the tissue receiving the massage.
6. Prognosis and Discussion It is worthy noting, resent study showed that the
This patient showed much promising improvement, in physiotherapy device HIVAMAT® 200 substantially
particular, regarding the interior bending and pronation suppressed both local inflammation in the lungs and redox
exercise after treated with HIVAMAT® 200 (Table 1). imbalance induced by quartz in the lungs of experimental
rats evidenced by the decrease of neutrophil content, protein
Table 1: The outcome of chronic inflammatory adhered musculi level, and GPx activity in the bronchoalveolar larvage (BAL)
extensor capri ulnaris and extensor digitorum communis after fluid as well as by the increase of reduced form glutathione
treated with HIVAMAT® 200 (GSH) concentration in the lung tissue. At the same time,
Parameters Before After HIVAMAT® 200 did not affect generalized oxidative stress
Strength (kg) <0.5 2.5 in the blood. HIVAMAT® could be recommended for the
Shaking frequency, (#/min) 1/15 1/32 treatment of acute lung inflammations of different origin in
Interior bending, degree, a 45o 30o combination with conventional therapies (Mikhalchik,
Pronation angle, degree 70o 102o Titkova, Anurov, Suprun, Ivanova, Trakhtman & Reinhold,
Sound ‘Kachi!! big noise Lower sound 2005b).
Midnight pain always disappeared
aAngle ‘’ shown in Fig. 3.
7. Conclusion
Conclusively, HIVAMAT® 200 should be considered when
Technically speaking, the HIVAMAT 200™ produces its the soft tissue pains or chronic inflammation are not treatable
unique method of massage therapy based on the action of a by means of common physical therapy. Basically, massage
pulsating, low-frequency, two-phase alternating electrostatic with HIVAMAT® 200 consists of several sequences. With
field generated between the practitioner’s hands and client’s HIVAMAT® 200, the patient can acquire an extremely
skin (ebay net, HIVAMAT® 200 Physical Therapy, 2013). versatile massage-intensifying system depending on the
When the HIVAMAT 200™ is applied to the patient’s body, frequency range selected.
the patient’s tissues (skin, connective, and muscular) will be
rapidly — but gently — pulled up and down. These quickly 8. References
moving and soft vibrations safely generate several effects to 1. Aliyev R. Klinische Wirksamkeit des
your body’s tissues, including 1) decongestive (to reduce Therapieverfahrens Tiefenoszillation bei
swelling and eliminate toxins); 2) anti-spasmodic (to relieve Sportverletzungen. (Clinical effectiveness of Deep
muscle tension and cramps); 3) normalization of tone (to Oscillation® in the treatment of sport injuries).Sportverl
improve muscle function), 4) improvement in
Sportschad 2009; 23:1–4.
microcirculation (to bring more blood to the region); and 5)
promote better tissue integrity and nourishment (to enhance
cellular metabolism) (ebay net: HIVAMAT® 200 Physical
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International Journal of Multidisciplinary Research and Development
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D. Treatment of Gynoid Lipodystrophy (Cellulite) with right for you. Deep Oscillation® positively influences
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29th. Annual Meeting of The Bioelectromagnetics
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